The web is majestic and grand, but filled with mixtures of good and bad reporting and advice. Here I have picked out of a simple Google search – kidney stones – some sites I can recommend. For these I try to make clear what I see in them as well as limitations.

kidneystoners.org

The featured site, though not ‘.edu’ is in fact a university level site run by distinguished experts and thoughtful patient advocates. It has a lot of patient content as well as medical materials, and the quality is very high.

Dr Mike Nguyen,  Associate Professor of Clinical Urology at the Keck School of Medicine of USC in Los Angeles, CA, founded this site years ago and it has grown into a wonderful resource for patients. He is a superb stone surgeon and offers patients opportunities to ask questions and also write posts about their own personal experiences.

I am impressed with the level of patient involvement, and the strong orientation to the details of their clinical care.

From a scientific standpoint I think Dr Nguyen’s site is completely reliable, which is critical for patients and family members who want to be sure what they are reading is as true as science can make it.

Take a look at kidneystoners.org.

It is a site I can recommend without reservation: Quality, prominent medical director, university based, scientifically accurate, and very patient friendly.

Urology Care Foundation

A publication of the American Urological Association, this is a rich and accurate site written by experts. There is an ad for urology health magazine but laudably labeled as an adverstiement. One can download articles and one I opened was written by experts I recognize as my peers. Some articles have a decided tilt toward eating lemons, but we can accept that as of as little harm as proven good. No patient posts. I favor Kidneystoners.org for its mix of rigor and bright patient activity, but this site has the same seriousness and reliance on people who really know a lot about the disease.

Mayo Clinic

Reliable, honest, useful. The focus is on essentials. There are ads. The site is oriented to attracting patients. But Mayo is an excellent center for kidney stone care, and in this age no one can afford to be shy. The site has no direct patient presence, by design, but is edited well and has illustrations.

National Institutes of Health 

Reliable, sparse. Just the bare facts, and directions to ask your health care professional. There is no patient presence. No ads.

National Kidney Foundation

The main site is about the same level of detail as Mayo Clinic. It offers 6 related linked articles. The related links are a more detailed but raise some concern. For example only fruits and veggies and less meats are recommended for uric acid stones. That is not a fair statement as potassium alkali produce a more reliable increase of urine pH. Likewise, high protein intake is put forward as a cause of the low urine pH, but in fact other renal factors predominate and are not mentioned. The article on calcium oxalate stones fails to mention idiopathic hypercalciuria, thiazides, or even bone disease as a complication. No ads, but donations are solicited.

PubMed Health

An offshoot of the main repository of medical knowledge, this site attempts to give consumers a sense for contemporary evidence about diseases and their treatments. Unfortunately the site is imprisoned by admirable doctrines that can be carried too far.

If one is totally pure, as an example, even water as a treatment for stones has not been rigorously proven effective – only one randomized trial so far, and one should want many more. So far as diet changes or medications, no trials satisfy rigorous evidence based medicine. Therefore, it could appear that nothing can be done while we await more trials.

I passionately argue that however laudable the philosophy, the result can be a clinical nihilism and futility that satisfies no one. This is especially true for stones whose treatments are inexpensive and with little capacity for harm vs. the massive cost and miseries of all surgery. Even more, given the ideal diet for stone prevention matches the diet recommended for everyone in the US, do we actually need or care to perform another diet trial? No ads.

Harvard Medical School

A lauded institution, this is part of their health publications program and has popped up ads for that product. The six experts listed for the kidney stone article appear to be editors and do not include, as an example, Dr Gary Curhan who is indeed an expert on kidney stones and works at that institution. Though nicely edited the article is very simplified and incomplete compared to the others I have noted. There are patient posts.

Wikipedia

A long article, rather diffuse, and variable in quality. I have no right to criticize as other established experts, myself included, might have put forth some energy to perfect it. I did not. I would advise patients to read the article but not use it in the same way as the ones from established institutions. The latter is more reliable. This one is lavish but not reliable enough for patients to rely on. References abound but their translation into a narrative can be a bit loose. No ads, of course.

University of Michigan

Although under an august banner, this article was produced by a commercial firm called Healthwise. The university carefully makes this fact clear. I read through some links concerning prevention of stones and found rather sparse material. No Ads except for the university itself which is in fact an outstanding institution.

Jill Harris Coaching

Jill Harris is a professional colleague who has written many articles with me or alone on this site. She offers a unique web-based course to aid patients in changing their diets to the Kidney Stone Diet, and maintaining long term adherence. Her site has patient-oriented articles focused on diet. It advertises her diet course and is the only sales outlet for it.  She runs and monitors a closed Facebook page for patients: ‘The kidney stone diet and prevention program’, found on Facebook.